Janice - Interview 37

Age at interview: 59
Brief Outline: Janice took HRT for 5 years which stabilised her periods, gave her energy and improved her memory. Since going off HRT at her GP's insistence, she has experienced low moods, forgetfulness and vaginal dryness. She feels the menopause is like a bereavement.
Background: Janice is a health worker. She is divorced with three adult daughters. She started the menopause at age 45 and had her last period at 57. Ethnic background/nationality' White British.

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From her mid-forties, Janice’s periods became longer, lasting up to two weeks. Consulting her GP, she was prescribed HRT, initially in the form of patches. These proved unsuitable, however, increasing her bleeding and leaving her severely anaemic. After switching to tablets, she felt much better, with the HRT regulating her periods, giving her an energy boost and sharpening her memory.

Five years later however, Janice was ‘just devastated’ when her GP refused to write another prescription, basing his decision on research suggesting an increased risk of breast cancer. Despite Janice protesting that she needed to remain on HRT to carry out her role as a carer for her disabled daughter, her doctor remained adamant, suggesting she try red clover instead. Janice still feels angry that ‘a decision was made to deny me a therapy which I found beneficial’.

Since going off HRT, Janice’s feelings of well-being have been replaced by low moods, vaginal dryness, restless legs, weight gain, and aches and pains. Herbal remedies have had little effect. She sometimes worries she has dementia, finding it frustrating when she misspells words or forgets people’s names and birthdays. Weight gain has left her feeling disappointed with her body image, and her interest in sex has waned.

For Janice, the menopause has been like a bereavement. Rather than feeling liberated by the loss of periods, she feels that the ‘thread back to her youth’ has been broken. In a society which fails to ‘value experienced older women’, she feels cut adrift, with just ‘a journey into ageing’ ahead of her. She believes that menopausal women are not taken seriously. She recommends that ‘every GP should have some kind of training in menopause’ and that surgeries should offer a clinic where women can meet to discuss menopausal issues.

Janice was interviewed for Healthtalkonline in June 2009.

Janice feels the void in her life now that she can no longer have children. She has ‘outlived her...

Janice feels the void in her life now that she can no longer have children. She has ‘outlived her...

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How did you feel about the loss of your fertility?

Sad. Sad because I thought you’ve lost one of your main reasons as a woman, your womb. Because I loved being pregnant. I loved having my children and you just think that’s gone then isn’t it. And if there’s a void, what do you put in that void? I haven’t found anything yet to put in that void. So it’s very strange.

It just makes you feel that you’ve come to a certain point in your life journey where you’ve outlived your usefulness, your contribution to society. You’re no longer going to be productive. You may be financially productive but that’s only time limited too but your main womanly production has stopped. Men are still valued as studs for until they’re 70 but as a woman I just think there’s nothing that seems to make you feel valuable. I think in our society we don’t value experienced older women. We make up funny names for them, nasty names for them or scorn older women, same as news readers. We’re not allowed to see older women reading the news. I mean, what’s all that about. So the messages out there are “Keep off the TV screens if you’re looking postmenopausal.” So it’s very discouraging. You feel at one time that you did have something to offer and contribute and then suddenly you’re in a void or limbo where there’s nothing.

Yes, my periods just stopped. Just like that. I’ve never had one since and you would think that would be a joy but it’s not. It’s joy less for me because it’s severed the thread I had with that young girl, that young woman who first started her periods. It’s gone. It’s severed off and she’s no longer there now. I feel very much adrift. It’s an incomplete journey so here I am. I’m nearly 60 and you sort of have to find your own niche in life but what are you good for? You don’t feel you’re good for anything.

Janice's doctor refused to give her another prescription for HRT after 5 years. She was devastated that her choice had been taken away but did not want to change doctors.

Janice's doctor refused to give her another prescription for HRT after 5 years. She was devastated that her choice had been taken away but did not want to change doctors.

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I liked being on it actually. It seemed to give me some kind of energy boost and it sharpened my memory. So I felt better on HRT. Anyway, all this story took about five years to come round. I went down to the GP. It was a female doctor who said, “Oh, you’ve been on it for five years I’m not going to give you another prescription for it.” And I said, “But I want to be on it.” She says, “Yes, but there’s research coming out what’s showing there’s a higher risk of breast cancer.” And I did say, “Well, I don’t smoke. I don’t drink a lot, maybe half a glass of lager or something a night, maybe five nights, four nights, nothing heavy. Could I stay on it?” But the doctor was adamant I couldn’t continue on that.

So I was brought off HRT and I found after that oh, it were terrible, absolutely. I were weepy. I were feeling depressed well, I’ve had depressed days. I just imagined this must be what depression feels like. I just couldn’t remember things. I were dull. I needed a sharp memory, a clearer memory in my job and it were terrible. So I went back to the GP and it were a male GP I got this time and I just begged, “Could I have HRT please?” And he said, “Well, we’d rather not.” And I said, “Well, I’ve got all the pressures from being a carer. I’m getting really weepy. I’m driving along the road and I just want to cry.” And he prescribed me some red clover and I tried that for about three months but it made no impact whatsoever.

So I just felt, this is it then. I’ve had my five years worth or whatever they consider you can have and I were just devastated. And I just think it was I’ve had my choice taken away from me. I wanted to stay on it. I felt better much better on it and I just couldn’t understand why somebody else had made that choice for me. They weren’t in my body and they weren’t living my life but yet a decision were made to sort of deny me a therapy which I found beneficial. And I did get the feeling somewhere along the line that it were viewed as women trying to clutch on to youth and really we should go into older age more gracefully, not need pharmacological, crutches or interventions. It were, “So get on with it”. And I’ve never been back since although I bet once a week at least I think, “Oh, I wish I could have my HRT.”

Is there a reason why you wouldn’t shop around and go elsewhere?

I would say in [city] there’s a culture of you stay with the same GP unless you move. I would say in [city] not many people do shop around, it’s often, “Oh, better the devil.” And then you hear shock, horror stories of other GPs and you think, “I’d better stop with mine.”

Janice doesn't feel it's right for her to challenge her GP or change practices.

Janice doesn't feel it's right for her to challenge her GP or change practices.

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So I got this book, bought this book and it was very interesting and it said you could have tests, is it FSH tests or something and I thought, “Dare I go down to the GP and ask for that. I think I’ll, you know.” It’s far too overly educated here because you’ve got to adopt a certain role for certain GPs. You don’t want to go and give them the impression that you’re more knowledgeable than them. It’s like women don’t. Often in society you have to play a role that you’re not very clever. So you have to play to type don’t you so no, I didn’t. I thought well, it must be lovely if you’ve got that test. You’d have some confirmation one way or the other so I did read lots of interesting things but I couldn’t relate it to what I could do for myself.

I would say in [city] there’s a culture of you often stay with the same GP unless you move. I would say in [city] not many people do shop around, it’s often, “Oh, better the devil you know”, and then you hear shock, horror stories of other GPs and you think, “I’d better stop with mine.” So that I would say in [city] currently, whether that changes with the new NHS Choices or Choose and Book [a service that allows you to choose your hospital or clinic and book an appointment with a specialist], people don’t often change GPs through wanting a different medication.

Janice is disappointed with her body image and wants to feel attractive.

Janice is disappointed with her body image and wants to feel attractive.

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It’s certainly much more difficult to lose weight, absolutely. I think it’s stubborn. So again, your body image doesn’t fit in with what we’re told we should look like in films or whatever. So you’re left a bit disappointed with your own body image. There’s only the Dove one perhaps which might celebrate older women but apart from that you’re just often you feel like you’re at society with your nose pressed up against the window. That you used to be in that shop. You might have been actually in the window as window dressing. You’re no longer window dressing.

I think the main thing is in partly you can discard having to dress up and attract men. That’s a big plus. You can actually dress for yourself and although that’s like saying a conflict with wanting to be attractive but it’s not to attract, the attraction I want to have is not to attract men. I just want to feel attractive as a person. It isn’t to attract the opposite sex like it might have been when I were younger. So perhaps that is a bonus that you can dress to please yourself and in a way feel comfortable in your own skin but still that conflict’s there. It never seems to go away, that loss because that’s the only way I can term it, as a bereavement.

Janice feels that society does not value older women.

Janice feels that society does not value older women.

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I just think that when you start your periods you hop on this bus and everybody’s welcoming you, “Come on you’re with us. Ah, it’s a fantastic thing. You’re coming into womanhood. Get on the bus.” And then get to fiftyish and it’s, “Get off the bus now, go on, you’ve had your bus ride.” And you’re sort of left there and you sort of know what’s facing you. You haven’t got the resources. You see your skin ageing and you see lots of things around you ageing and unless you can afford Botox or plastic surgery, what’s in store for you is just a journey into ageing, which is not what our society in Britain values. So it’s quite depressing, what’s at the end of that journey don’t you, and there’s nothing really what you’re allowed to support you. There doesn’t seem to be any support. There’s nothing for me to celebrate being menopausal at all.

Janice wants partners to make women feel valued.

Janice wants partners to make women feel valued.

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What advice would you give partners of women going through the menopause?

To pay them compliments to make women feel women. Not that you have to be constantly saying, “You do look pretty.” It’s not about being pretty. It’s about being valued. You might have a certain outfit on and just being told, “That really goes well with your skin.” Or you have your hair done, “Your hair really looks good today.” It’s just little things like that. Not necessarily buying flowers and chocolates because chocolates when you’ve got your middle-aged spread. Love ‘em but you think, “Oh, chocolates.” So, and flowers well, they shrivel up like your skin shrivels up. You get messages all round you that you’re shrivelling up and your skin’s like a leaf isn’t it.